CN107440753B

CN107440753B - Endoscopic suturing device

Info

Publication number: CN107440753B
Application number: CN201710391510.XA
Authority: CN
Inventors: 雅各布·巴里尔
Original assignee: Covidien LP
Current assignee: Covidien LP
Priority date: 2016-05-31
Filing date: 2017-05-27
Publication date: 2021-06-29
Anticipated expiration: 2037-05-27
Also published as: US20170340320A1; US10542970B2; CN107440753A; EP3251609A3; EP3251609A2; JP2017213369A

Abstract

The present disclosure provides an endoscopic suturing device, and an elongated shaft assembly for the suturing device, the elongated shaft assembly including a hub assembly and an end effector. The hub assembly includes an insertion portion and an engagement portion. The insertion portion includes: a main rod; a rotatable hub operatively coupled with the main rod such that axial displacement of the main rod rotates the rotatable hub; and first and second arms, the The first and second arms are operatively coupled with the rotatable hub such that rotation of the rotatable hub causes reciprocating axial displacement of the first and second arms. The engagement portion is moveable relative to the insertion portion between a reload position and a loaded position in which the rotatable hub is in a distal-most position and can be independent of the shaft of the main rod Rotating toward displacement, in the loaded position, axial displacement of the main rod rotates the rotatable hub.

Description

Endoscopic stitching device

Cross Reference to Related Applications

This application claims benefit and priority from U.S. provisional patent application No. 62/343,379 filed on 31/5/2016, the entire contents of which are incorporated herein by reference.

Technical Field

The present disclosure relates to devices for use in stitching or suturing, and more particularly, to devices for endoscopic stitching and/or suturing via an access tube or the like.

Background

One of the recent advances in reducing the invasiveness of surgical procedures is endoscopic surgery. Generally, endoscopic surgery involves making an incision through the body wall. Typically, trocars are used to create incisions through which endoscopic procedures are performed. The trocar body or cannula device extends into the abdominal wall and is left in place to provide access for endoscopic surgical tools. A camera or endoscope is inserted through the larger diameter trocar body generally at the umbilical incision and allows visual inspection and magnification of the body cavity. The surgeon may then perform diagnostic and therapeutic procedures at the surgical site with the aid of specialized instruments such as forceps, cutters, applicators, etc. designed to fit through the additional cannula.

In many surgical procedures, including those involved in endoscopic surgery, it is often necessary to mend a body organ or tissue. The mending of bodily organs or tissues during endoscopic surgery can be challenging because the mending must be done through a small opening. Accordingly, there is a need for a simple and effective device for endoscopic stitching or suturing.

Disclosure of Invention

The present disclosure describes a device for use in patching and stitching that exemplifies a practical approach to meeting performance requirements and overcoming usability challenges associated with endoscopic patching or stitching. In accordance with an embodiment of the present disclosure, an endoscopic stitching device is provided that includes a handle assembly and an elongate shaft assembly. The handle assembly includes a trigger. The elongate shaft assembly includes a hub assembly and an end effector.

The hub assembly includes: a main stem operatively associated with the trigger of the handle assembly; a rotatable hub operatively coupled with the main shaft such that axial displacement of the main shaft rotates the rotatable hub; and first and second arms operatively coupled with the rotatable hub such that rotation of the rotatable hub causes reciprocal axial displacement of the first and second arms. The end effector includes first and second jaws and first and second needle-receiving blades slidably disposed in the respective first and second jaws. The first and second jaws are operatively coupled with the main rod of the hub assembly such that axial displacement of the main rod pivots the first and second jaws between open and closed positions. The first and second needle-receiving blades are operatively coupled with respective first and second arms of the hub assembly such that reciprocal axial displacement of the first and second arms causes reciprocal axial displacement of the first and second needle-receiving blades.

In an embodiment, the rotatable hub may define an outer cam track configured to slidably engage the first and second arms of the hub assembly therein. The outer cam track may define a helical groove. The outer cam track may include distal and proximal portions, wherein at least one of the distal or proximal portions may extend transverse to a longitudinal axis defined by the rotatable hub.

In yet another embodiment, the rotatable hub may further define an inner cam path in an inner surface thereof. The inner cam path may define a pair of spaced helical grooves and a pair of opposed axially directed grooves interconnecting the helical grooves.

In yet another embodiment, the first and second arms of the hub assembly may be diametrically opposed to each other.

In yet another embodiment, the primary lever may include a cam pin extending laterally outward. The cam pin may be configured to slide through the inner cam path of the rotatable hub to cause rotation of the rotatable hub.

In another embodiment, the handle assembly may further comprise a drive plunger operatively associated with the main shaft of the hub assembly, wherein actuation of the trigger may advance the drive plunger distally.

In yet another embodiment, the main rod may be movable between a proximal position in which the cam pin is proximal to the rotatable hub and a distal position in which the cam pin is received within the inner cam path. The main shaft may be biased toward the proximal position.

In accordance with another embodiment of the present disclosure, an elongate shaft assembly for an endoscopic stitching device is provided. The elongate shaft assembly includes a hub assembly and an end effector. The hub assembly includes an insertion portion and an engagement portion. The insertion portion is configured to be received in a handle assembly of the endoscopic stitching device. The insertion portion includes: a main rod; a rotatable hub operatively coupled with the main shaft such that axial displacement of the main shaft rotates the rotatable hub; and first and second arms operatively coupled with the rotatable hub such that rotation of the rotatable hub causes reciprocal axial displacement of the first and second arms. The engagement portion is movable relative to the insertion portion between a reload position, in which the rotatable hub is in a distal most position and is rotatable independently of the axial displacement of the main rod, and a loaded position, in which the axial displacement of the main rod rotates the rotatable hub.

The end effector includes: first and second jaws operatively coupled with the stem such that axial displacement of the stem pivots the first and second jaws between open and closed positions; and first and second needle-receiving blades slidably disposed in the respective first and second jaws. The first and second needle-receiving blades are operatively coupled with respective first and second arms of the hub assembly such that reciprocal axial displacement of the first and second arms causes reciprocal axial displacement of the first and second needle-receiving blades.

In an embodiment, the engagement portion of the hub assembly may be biased towards the reloading position.

In another embodiment, the hub assembly may further comprise a latch for selectively securing the engagement portion in the reloading position or the loaded position. The insertion portion may define a locking slot to secure the latch therein. The rotatable hub may define a locking recess to secure the latch therein.

Drawings

The above objects, features and advantages of the present disclosure will become more apparent from the following description when read in conjunction with the accompanying drawings, in which:

FIG. 1 is a perspective view of a suturing device according to an embodiment of the present disclosure;

FIG. 2 is a cross-sectional view of a handle assembly of the suturing device of FIG. 1;

FIG. 3 is a perspective view of the suturing device of FIG. 1 illustrating the removability of the handle assembly and the elongate shaft assembly;

FIG. 4 is a perspective view of a hub assembly of the elongate shaft assembly of FIG. 3;

FIG. 5 is a top view of the rotatable hub of the hub assembly of FIG. 4;

FIG. 6 is a cross-sectional view of the inner surface of the rotatable hub of FIG. 4, showing the inner cam path thereof;

FIG. 7 is a schematic view of the inner surface of the rotatable hub of FIG. 4, showing the cam path therein;

FIG. 8 is a top view of the rotatable hub of FIG. 5 showing the inner cam path in phantom;

FIG. 9 is a partial cross-sectional view of an end effector of the elongate shaft assembly of FIG. 1;

FIG. 10 is a side view of a jaw member for the end effector of FIG. 9; and

FIG. 11 is a top view of a hub assembly for the suturing device of FIG. 1 in accordance with an embodiment of the present disclosure.

Detailed Description

Embodiments of the present disclosure will now be described in detail with reference to the drawings, wherein like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term "distal" refers to that portion of an instrument, device, apparatus, or component thereof that is farther from the user, as is conventional, while the term "proximal" refers to that portion of the instrument, device, apparatus, or component thereof that is closer to the user. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the disclosure in unnecessary detail.

Referring to fig. 1, an embodiment of the present disclosure is generally illustrated as a suturing apparatus 1000. The suturing device 1000 is adapted to be particularly useful for endoscopic or laparoscopic procedures wherein an endoscopic portion of the suturing device 1000, such as the end effector 300, may be inserted into a surgical site via a cannula assembly or the like (not shown). The stapling device 1000 includes a handle assembly 100 and an elongate shaft assembly 200 extending distally from the handle assembly 100. As described below, the handle assembly 100 and the elongate shaft assembly 200 can be removably coupled. Such a configuration facilitates, for example, sterilization of the stapling apparatus 1000 and interchangeability of the end effector 300.

Referring to fig. 1 and 2, the handle assembly 100 includes a trigger 104 pivotally supported on the housing 102 and a drive plunger 120 operatively coupled to the trigger 104. A drive plunger 120 is slidably supported within the housing 102. The drive plunger 120 defines a proximally extending trigger slot 120b formed in a proximal portion thereof to operatively receive the drive arm 104b of the trigger 104. The trigger slot 120b defines a distal surface or wall 120c against which the distal surface of the drive arm 104b of the trigger 104 abuts to distally advance the drive plunger 120 during actuation of the trigger 104.

The handle assembly 100 further includes an endoscope assembly release lever 130 pivotally supported on the housing 102 via a pivot pin 132 and connected to the housing 102. The release lever 130 includes a distal side 130b that extends distally of the pivot pin 132. The distal side 130b of the release rod 130 includes a hook or tooth 130d projecting therefrom in a direction toward the drive plunger 120. The hook 130d may be located distal to the drive plunger 120. A biasing member 134, for example in the form of a leaf spring (leaf spring), may be provided to bias the hook 130d towards the drive plunger 120. Biasing member 134 holds hook 130d of release lever 130 in engagement with annular recess 212c (fig. 3) of endoscope assembly 200. The handle assembly 100 may further include a knob 160, the knob 160 being rotatably supported on the housing 102 to enable concomitant rotation of the end effector 300. Reference may be made to U.S. patent No. 7,905,890 entitled "Endoscopic Surgical Clip Applier" or U.S. provisional patent application No. 62/253,162 entitled "Endoscopic reusable Surgical Clip Applier" filed 11/10 2015, the entire contents of each of which are incorporated herein by reference for a detailed discussion of the structure and operation of the handle assembly.

Referring to fig. 3 and 4, the elongate shaft assembly 200 is detachable from the handle assembly 100. The elongate shaft assembly 200 includes a hub assembly 210, an elongate shaft 220, and an end effector 300 operatively coupled with the trigger 104 of the handle assembly 100. The hub assembly 210 serves as an adapter assembly for selective connection to the knob 160 of the handle assembly 100. Hub assembly 210 includes an insertion portion 210a and an engagement portion 210b extending distally from insertion portion 210 a. The insertion portion 210a is configured to be received within the handle assembly 100. When the insertion portion 210a is secured with the handle assembly 100, the engagement portion 210b is disposed adjacent the knob 160.

The insertion portion 210a can define an annular recess 212c, the annular recess 212c configured to removably receive the hook 130d (fig. 2) of the release lever 130 to secure the elongate shaft assembly 200 with the handle assembly 100. Further, the insertion portion 210a includes a circumferentially arranged rib 212d (fig. 4). Complementary slots 160b (FIG. 3) are defined in the knob 160 of the handle assembly 100 such that the ribs 212d are slidably received in the corresponding slots 160b of the knob 160 of the handle assembly 100 during connection of the elongate shaft assembly 200 and the handle assembly 100. The coupling of the hub assembly 210 of the elongate shaft assembly 200 to the knob 160 of the handle assembly 100 enables the elongate shaft assembly 200 to rotate about its longitudinal axis relative to the handle assembly 100.

Referring to fig. 4 and 5, the insertion portion 210a of the hub assembly 210 includes a drive conversion assembly 400, the drive conversion assembly 400 being configured to convert axial displacement of the drive plunger 120 of the handle assembly 100 into rotation of the rotatable hub 405 so as to provide axial output of the main rod 156 and axial output of the first and

second arms

420, 422 reciprocating in opposite directions. As will be discussed below, the main rod 156 is operatively coupled to the

jaws

130, 132 of the end effector 300, and the rotatable hub 405 (i.e., the first and second arms 420, 422) is operatively coupled to a pair of needle engaging members or blades 150, 152 (fig. 9) of the end effector 300.

Hub assembly 210 defines a proximal opening 212e, proximal opening 212e configured to slidably receive drive plunger 120 of handle assembly 100 when elongate shaft assembly 200 is coupled to handle assembly 100. The main rod 156 includes a proximal end 156a configured to engage the drive plunger 120 of the handle assembly 100 and a distal end (not shown) connected to the jaws 130, 132 (fig. 9) of the end effector 300. The main lever 156 includes a cam pin 401 extending laterally outward. A biasing member 403, such as a compression spring, is interposed between the proximal end 156a of the main rod 156 and the rotatable hub 405 such that the main rod 156 is biased toward the initial position.

With continued reference now to fig. 4 and 5, rotatable hub 405 is configured to be rotatably disposed within hub assembly 210. Rotatable hub 405 defines a lumen 407, lumen 407 being configured to slidably receive main rod 156 therethrough. Rotatable hub 405 defines an outer cam track 409 (fig. 5) in the form of, for example, a helical or spiral groove in its outer surface and an inner cam path 411 (fig. 6) on its inner surface.

Referring to fig. 5-7, the distal and proximal ends of the outer cam track 409 may extend transverse to the longitudinal axis "X-X" (fig. 5) of the rotatable hub 405. The inner cam path 411 defines a pair of spaced apart helical grooves 411a formed in an inner surface of the rotatable hub 405 (fig. 5) and a pair of opposing axially oriented grooves 411b formed in the inner surface of the rotatable hub 405 and interconnecting the helical grooves 411 a.

Referring to fig. 8, hub assembly 210 further includes a first arm 420 and a second arm 422 operatively coupled to blades 150, 152 (fig. 9) of end effector 300. The first arm 420 and the second arm 422 are diametrically opposed to each other. The first and

second arms

420, 422 include

respective bosses

420a, 422a slidably received in the outer cam track 409 of the rotatable hub 405. The cam pin 401 extending transversely from the main rod 156 is sized to slidably engage in the inner cam path 411 of the rotatable hub 405. In this configuration, as main rod 156 is advanced distally,

jaws

130, 132 transition to the closed position, and camming pin 401 slidably engages inner cam path 411, thereby rotating rotatable hub 405. As the rotatable hub 405 rotates, the

respective bosses

420a, 422a of the first and

second arms

420, 422 ride within the outer cam track 409 of the rotatable hub 405 and are axially displaced in opposite directions. Axial displacement of the first and

second arms

420, 422 in opposite directions causes reciprocating motion of the blades 150, 152 (fig. 9) of the end effector 300. In this manner, separate actuation of the trigger 104 causes both axial displacement of the main rod 156 and reciprocal displacement of the first and

second arms

420, 422, which effect opening and closing of the

jaws

130, 132 and reciprocal axial displacement of the

blades

150, 152, respectively.

Referring to fig. 9, the elongate shaft assembly 200 includes an end effector 300. End effector 300 includes a support member 122 and

jaws

130, 132 pivotally mounted on support member 122 by way of a jaw pivot pin 134. To move

jaws

130, 132 between the open and closed positions, main rod 156 has a camming pin (not shown) mounted at a distal end 156a thereof. Camming pin 138 rides in an angled camming slot 130c (fig. 10) defined in

respective jaws

130, 132 such that axial or longitudinal movement of main rod 156 causes

jaws

130, 132 to cam between an open position and a closed position. For example,

jaws

130, 132 transition to a closed position as stem 156 is advanced distally.

End effector 300 further includes a pair of needle engaging members or

blades

150, 152 slidably supported within support member 122. Each

blade

150, 152 includes a

distal end

150a, 152a, the

distal ends

150a, 152a slidably extending into the blade-receiving

channels

130d, 132d of the

respective jaws

130, 132. The

channels

130d, 132d are sized to at least partially intersect the

needle recesses

130a, 132 a. Thus, when at least a portion of the needle 107 is received within the

respective needle recess

130a, 132a, the

distal ends

150a, 152a of the advancing

blades

150, 152 engage or "lock" in the slot 107a formed in the needle 107 by advancing the

blades

150 or 152 within the

respective channels

130d, 132 d. A suture (not shown) may be secured to the needle 107. The suture may include a plurality of barbs oriented to resist movement in a direction opposite the direction of travel.

Referring to fig. 3 and 4, in use, the insertion portion 210a of the hub assembly 210 is received in the handle assembly 100 such that the hook 130d (fig. 2) of the release lever 130 securely engages the annular recess 212c defined in the insertion portion 210a of the hub assembly 210. At this point, a portion of drive plunger 120 is received through proximal opening 212e of hub assembly 210.

Referring to fig. 9, initially, the notches (not shown) formed in the

respective blades

150, 152 are aligned or registered with the

respective needle recesses

130a, 132a defined in the

respective jaws

130, 132. With the notches of the

blades

150, 152 aligned or registered with the

respective needle recesses

130a, 132a of the

respective jaws

130, 132, the needle 107 may be positioned or loaded into a selected one of the

needle recesses

130a, 132a of the

jaws

130, 132.

Once the needle 107 is loaded into one of the

needle recesses

130a, 132a of the

jaws

130, 132, the trigger 104 is actuated to rotate the rotatable hub 405, which in turn causes reciprocal axial displacement of the first and second arms 420, 422 (fig. 4) such that only one of the

blades

150, 152 is engaged with the needle 107 while the other of the

blades

150, 152 is disengaged from the needle 107. With only one of the

blades

150, 152 engaged with the needle 10, the trigger 104 may be released, thereby moving the main rod 156 proximally to open the

jaws

130, 132.

With

jaws

130, 132 in the open position and needle 107 loaded and held in one of

jaws

130 or 132,

jaws

130, 132 may be positioned around or over a target tissue and handle 110 may be actuated to

approximate jaws

130, 132. As

jaws

130, 132 are approximated, the exposed end of needle 107 penetrates through the target tissue and into the opposing

jaw

130 or 132. With the needle 107 in the

opposite jaw

130 or 132, the

blades

150, 152 are exchanged as the stem 156 is further advanced. In doing so, the needle 107 is swapped from one

blade

150 or 152 to the

other blade

150 or 152 to be loaded or held in the

other jaw

130 or 132.

With the needle 107 swapped from one

blade

150, 152 to the

other blade

150, 152, the trigger 104 can be released, causing the

jaws

130, 132 to open and draw the needle 107 through the target tissue. In doing so, the suture is also drawn through the tissue. The process is repeated: the needle 107 is passed between the

jaws

130, 132 and the suture is drawn through the target tissue to mend the target tissue as needed or desired.

Referring now to fig. 11, a hub assembly 510 is shown according to another embodiment of the present disclosure. Hub assembly 510 includes the same features as described with respect to hub assembly 210. Accordingly, like parts in the hub assembly 510 will not be described herein to avoid obscuring the disclosure in unnecessary detail.

The hub assembly 510 includes an insertion portion 510a and an engagement portion 510b distal of the insertion portion 510 a. The insertion portion 510a is configured to be received within the handle assembly 100. When coupled with the handle assembly 100, the engagement portion 510b is disposed adjacent the knob 160 (fig. 3). Hub assembly 510 further includes a reload mechanism 550, reload mechanism 550 configured to transition blades 150, 152 (fig. 9) of end effector 300 to a reload mode. In the reload mode, each

blade

150, 152 of the

respective jaw

130, 132 is in a distal-most position. In this manner, the notches (not shown) formed in the

respective blades

150, 152 are aligned or registered with the

respective needle recesses

130a, 132a defined in the

respective jaws

130, 132. With the notches of

blades

150, 152 aligned or registered with

respective needle recesses

130a, 132a of

respective jaws

130, 132, needle 107 (fig. 2) may be positioned or loaded into a selected one of

needle recesses

130a, 132a of

jaws

130, 132.

The engaging portion 510b is movable relative to the insertion portion 510 a. The reloading mechanism 550 comprises a latch 552, the latch 552 being configured to be received in a locking recess 560 of the rotatable hub 505 or a locking slot 554 defined in the insertion portion 510a, whereby the engagement portion 550b is transitionable between a reloading position, in which the latch 552 is received in the locking recess 560 defined in the rotatable hub 505, and a loaded position, in which the engagement portion 510b is pulled proximally, such that the latch 552 is received in the locking slot 554 of the insertion portion 510 a. When the latch 552 is received in the locking recess 560 defined in the rotatable hub 505, relative rotation between the engagement portion 510b and the rotatable hub 505 may be inhibited.

In the reloading position, rotatable hub 505 is in a distal-most position. At this time, the cam pin 509 on the main rod 156 is disposed proximal to the rotatable hub 505 or an internal cam path (not shown) defined in an inner surface of the rotatable hub 505 such that the rotatable hub 505 can rotate independently of the axial displacement of the main rod 156. The rotatable hub 505 in the distal-most position enables the blade 150, 152 (fig. 2) of the

respective jaw

130, 132 to be in the distal-most position, which in turn enables the needle 107 to be loaded into a selected one of the

needle recesses

130a, 132a of the

jaws

130, 132. In the loaded position, the cam pin 509 is disposed in an internal cam path of the rotatable hub 505, whereby axial displacement of the main rod 156 causes transitioning of the

jaws

130, 132 between the open and closed positions and reciprocal axial displacement of the

blades

150, 152 in opposite directions. The hub assembly 510 may further include a biasing member 513, such as a compression spring, to bias the rotatable hub 505 toward the reloading position.

The insertion portion 510a of the hub assembly 510 includes a drive conversion assembly 500, the drive conversion assembly 500 being configured to convert axial displacement of the drive plunger 120 of the handle assembly 100 into axial displacement of the main rod 156 and rotation of the rotatable hub 505. The main rod 156 is operatively coupled to the

jaws

130, 132 of the end effector 300, and the rotatable hub 505 is operatively coupled to the

blades

150, 152 of the end effector 300 (fig. 9).

In use, the stapling apparatus 1000 is first transitioned to a reload mode by releasing the latch 552 and sliding the engagement portion 510b distally so that the two blades 150, 152 (fig. 9) are in a distal-most position. In this manner, the notches (not shown) formed in the

respective blades

150, 152 are aligned or registered with the

respective needle recesses

130a, 132a defined in the

respective jaws

130, 132. With the notches of the

blades

150, 152 aligned or registered with the

respective needle recesses

130a, 132a of the

respective jaws

130, 132, a needle 107 (fig. 9) may be positioned or loaded into a selected one of the

needle recesses

130a, 132a of the

jaws

130, 132.

At this time, the insertion portion 510a of the hub assembly 510 is received in the handle assembly 100 such that the hook 130d of the release lever 130 securely engages the annular recess 512c defined in the insertion portion 510a of the hub assembly 510. At this point, a portion of the drive plunger 120 is received in the proximal opening 512e of the hub assembly 510.

At this point, the trigger 104 (fig. 1) may be squeezed to cause axial displacement of the main rod 156, which in turn transitions the

jaws

130, 132 to the closed position and rotates the rotatable hub 505 such that only one of the

blades

150, 152 is engaged with the needle 107 (fig. 2) while the

other blade

150, 152 is disengaged from the needle 107. When trigger 104 is released, main rod 156 is displaced proximally, which in turn causes

jaws

130, 132 to open.

With

jaws

130, 132 in the open position and needle 107 loaded and held in one of

jaws

130 or 132,

jaws

130, 132 may be positioned around or over the target tissue and trigger 104 may be actuated to

approximate jaws

130, 132. As

jaws

jaw

130 or 132. With needle 107 in the

opposite jaw

130 or 132, lever 182 is again actuated or rotated so that

blades

150, 152 are exchanged. In doing so, the needle 107 is swapped from one

blade

150 or 152 to the

other blade

150 or 152 to be loaded or held in the

other jaw

130 or 132.

With the needle 107 swapped from one

blade

150, 152 to the

other blade

150, 152, the handle 110 can be released, thereby causing

jaws

Although the exemplary embodiments of the present disclosure have been described with reference to the accompanying drawings, the above description, disclosure, and drawings should not be construed as limiting, but merely as exemplifications of particular embodiments. For example, the elongate shaft assembly 200 can include an articulatable portion to facilitate maneuverability of the suturing device through the anatomy of a patient. It is to be understood that the present disclosure is not limited to those precise embodiments, and that various other changes and modifications may be affected therein by one skilled in the art without departing from the scope or spirit of the disclosure.

Claims

1. An endoscopic suturing device, comprising:

a handle assembly including: a trigger; and

An elongated shaft assembly comprising:

A hub assembly, which includes:

a main lever including a laterally outwardly extending cam pin and operatively associated with the trigger of the handle assembly;

a rotatable hub operatively coupled with the main rod such that axial displacement of the main rod rotates the rotatable hub; and

first and second arms operatively coupled with the rotatable hub such that rotation of the rotatable hub causes reciprocating axial displacement of the first and second arms; and

An end effector, which includes:

first and second jaws operatively coupled with the main rod of the hub assembly such that axial movement of the main rod between the first state and the second state position pivots the first and second jaws between open and closed positions, in the first state the cam pin of the main lever is disposed outside the rotatable hub and the rotatable hub rotatable independently of axial displacement of the main rod, in the second state the cam pin is disposed within the rotatable hub; and

first and second needle receiving blades slidably disposed in respective first and second jaws, said first and second needle receiving blades and said hub assembly The respective first and second arms of the are operatively coupled such that reciprocating axial displacement of the first and second arms causes reciprocating axial displacement of the first and second needle receiving blades.

2. The endoscopic stapling device of claim 1, wherein the rotatable hub defines an outer cam track configured to slidably engage the first and the hub assembly therein. second arm.

3. The endoscopic stapling device of claim 1, wherein the first and second arms of the hub assembly are diametrically opposed to each other.

4. The endoscopic suturing device of claim 2, wherein the outer cam track defines a helical groove.

5. The endoscopic stapling device of claim 4, wherein the outer cam track includes a distal and a proximal portion, at least one of the distal or proximal portion transverse to that defined by the rotatable hub extending along the longitudinal axis.

6. The endoscopic stapling device of claim 2, wherein the rotatable hub further defines an inner cam path in its inner surface.

7. The endoscopic stapling device of claim 6, wherein the cam pin of the main rod is configured to slide through the inner cam path of the rotatable hub to cause slidability of the rotatable hub rotate.

8. The endoscopic stapling device of claim 6, wherein the inner cam path defines a pair of spaced apart helical grooves and a pair of opposing axially oriented grooves interconnecting the helical grooves.

9. The endoscopic stapling device of claim 2, wherein the handle assembly further comprises a drive plunger operatively associated with the main rod of the hub assembly, wherein actuation of the trigger is distal Advance the drive plunger.

10. The endoscopic stapling device of claim 7, wherein the main rod is movable between a proximal position and a distal position in which the cam pin is in the rotatable hub On the proximal side, in the distal position, the cam pin is received within the inner cam path.

11. The endoscopic stapling device of claim 10, wherein the main shaft is biased toward the proximal position.

12. An elongated shaft assembly for an endoscopic suturing device, comprising:

A hub assembly, which includes:

an insertion portion configured to be received in a handle assembly of the endoscopic stapling device, the insertion portion comprising:

a main lever including a laterally outwardly extending cam pin;

an engagement portion movable relative to the insert portion between a reload position and a loaded position in which the rotatable hub is in a distal-most position and is capable of being independent of the shaft of the main rod rotating toward displacement, in the loaded position, axial displacement of the main rod rotates the rotatable hub; and

An end effector, which includes:

first and second jaws operatively coupled with the main rod such that axial displacement of the main rod between the first state and the second state causes the first and second jaws to be operatively coupled to the main rod. First and second jaws pivot between open and closed positions, in which the cam pin of the main lever is disposed outside the rotatable hub, and in the second state, the a cam pin disposed within the rotatable hub; and

13. The elongated shaft assembly of claim 12, wherein the engagement portion of the hub assembly is biased toward the reload position.

14. The elongated shaft assembly of claim 12, wherein the hub assembly further comprises a latch for selectively securing the engagement portion in the reload position or the loaded position.

15. The elongated shaft assembly of claim 13, wherein the rotatable hub defines an outer cam track configured to slidably engage the first and second portions of the hub assembly therein. Two arms.

16. The elongated shaft assembly of claim 15, wherein the rotatable hub further defines an inner cam path in an inner surface thereof.

17. The elongated shaft assembly of claim 16, wherein the cam pin of the main rod is configured to slide through the inner cam path of the rotatable hub to cause rotation of the rotatable hub.

18. The elongated shaft assembly of claim 17, wherein the main rod is rotatable between a proximal position and a distal position in which the cam pin is in a position of the rotatable hub Proximally, in the distal position, the cam pin engages within the inner cam path.

19. The elongated shaft assembly of claim 18, wherein the main shaft is biased toward the proximal position.

20. The elongated shaft assembly of claim 14, wherein the insertion portion defines a locking slot to secure the latch therein.

21. The elongated shaft assembly of claim 14, wherein the rotatable hub defines a locking recess to secure the latch therein.

22. The elongated shaft assembly of claim 12, wherein the first and second jaws of the end effector are operatively coupled with the main rod such that distal displacement of the main rod The first and second jaws are brought into proximity.